Objectives: This study was to evaluate the incidence, various risk factors, and clinical profile of ischemic stroke patients in Kosi region, Bihar, India. Methods: A detail history, clinical examinations and relevant investigations were performed to all ischemic stroke patients. Investigations were performed like as routine: complete hemogram, fasting blood sugar, urea, creatinine and urine for RE. Biochemistry: serum lipid profile (TCh ,LDL–C, HDL–C,TG,VLDL–C), serum lipoprotein(a). serum homocysteine, plasma fibrinogen. Comprehensive lipid Tetrad index:– TCh X TG x Lp(a), HDL. Cardiovascular: Chest X–ray PA view, ECG and Echo Doppler study. Neuroimaging: CT scan of Brain, MRI and MRA (where needed). Results: Data was analysed by using simple statistical methods with the help of MS–Office software. All data was tabulated and percentages were calculated. Conclusions: Patients in the above 5th to 7th decades of life are the most vulnerable to suffer ischaemic stroke. Males were commonly suffered. Hypertension is one of the most prevalent risk factors for ischemic stroke . And comprehensive lipid tetrad index has a direct relation with the incidence of ischemic stroke. So that, awareness regarding dietary habit and life style modifications are necessary for prevention from the risk of ischemic stroke.